Due to COVID-19, HCA’s lobby is closed. Learn more about your customer service options.

HCA is closed Thursday, November 26 and Friday, November 27. All Apple Health (Medicaid), PEBB, and SEBB customer services phones lines will be down after 5 p.m. Wednesday, November 25 through Monday morning, November 30.

Help for question 3

How much is/are the plan's out-of-pocket limits?

Where to look

You will see:

  1. "Is there an out-of-pocket limit on my expenses?" and
  2. "What is not included in the out-of-pocket limit?"

under "Important Questions" on the Summary of Benefits and Coverage.

Only look at amounts for a single person (or individual) using a preferred (or in-network) provider.


Screenshot of example plan with arrows point to out-of-pocket questions (rows 3 and 4) of the Important Questions/Answer table

How to answer

If you see

Answer like this:
Only one out-of-pocket limit (no separate out-of-pocket limit for prescription drugs)

Fill out A.

Skip B1 and B2.

Go to Question 4.

An out-of-pocket limit and a separate out-of-pocket limit for prescription drug coverage

Skip A.

Fill out B1 with the medical out-of-pocket limit.

Fill out B2 with the prescription drug out-of-pocket limit.

Go to Question 4.